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Biomedical subjects

S H Quak

Publications and source records attributed to S H Quak.

At least 73 records · Page 4Linked to original sources

Lactase insufficiency in Chinese children detected by oral milk and lactose challenge.

A study to determine the incidence of late-onset lactose intolerance was undertaken in 68 normal Chinese children in Singapore using measurements of breath hydrogen concentrations, following a lactose or milk challenge, as indicator of lactose malabsorption. Evidence of lactose malabsorption was detected in 26% of children given a lactose challenge, and in 21% of those given a milk challenge. It is concluded that late-onset lactase insufficiency is common in Chinese children in Singapore.

Animals↗

Hepatobiliary scintigraphy in the diagnosis of biliary atresia--a Singapore experience.

In recent years, 99mTechnetium IDA hepatobiliary scintigraphy has been widely accepted as a highly sensitive and fairly accurate test in the diagnosis of biliary atresia and evaluation of neonatal jaundice. Over a period of 4 years from 1982 to 1986, a total of 110 paediatric patients had undergone 99mTechnetium IDA hepatobiliary scans in our department for prolonged neonatal jaundice. Their scans were reviewed to evaluate the role of this nuclear imaging technique in the diagnosis of biliary atresia. There were 43 true positive and 49 true negative scans. No false negative scan was encountered in our study. Hence the sensitivity was 100%. However, out of the 110 scans, there was misdiagnosis of biliary atresia in 18 cases. This gave a specificity of 73% with an accuracy of 84%. From this study we concluded that 99mTechnetium IDA imaging is a highly sensitive test in the screening of biliary atresia. However, its specificity is possibly limited by the short half life of the radioisotope 99mtechnetium in delayed 24 hr imaging and we feel that this could be improved by using slightly higher doses than what we are presently using.

Biliary Atresia↗

Lactate production in type B hyperlactataemia due to infective encephalopathy.

We have suggested that the neuroglycopenia of infective encephalopathy results in increased lactate production in muscle as an alternative cerebral fuel. Two probable mechanisms for enhanced lactate production in infective encephalopathy are fatty acidaemia and increased LDH activity. Hyperglycaemia-producing infusions should then result in clinical and metabolic recovery. Twenty-two children with encepahlopathy were studied over 2 1/2 week periods. There was normoglycaemia at admission together with hyperlactataemia (p less than 0.004), fatty acidaemia (p less than 0.004) and increased serum LDH activity (p less than 0.005). Therapeutic hyperglycaemia resulted in recovery and a progressive return of metabolic aberrations to normality. Two case reports detail the responses to such management.

Blood Glucose↗

Delayed recovery following acute gastroenteritis in children.

The purpose of this study is to identify the factors which are responsible for the delayed recovery in acute gastroenteritis (GE) in children. 372 children admitted to the University Department of Paediatrics were reviewed. 29 children (7.8%) required prolonged hospitalisation because of diarrhoea (delayed recovery group) and 343 children (92.2%) had short hospitalisation (normal recovery group). There was no significant difference in terms of race, sex, duration of symptoms before admission and severity of dehydration between the two groups. However, those with delayed recovery were significantly younger (mean age 14.4 months) than the normal recovery group (mean age 23.3 months). In the delayed recovery group, 32% were due to bacterial diarrhoea compared to 5.0% in the normal recovery group (p less than 0.05). The body weight of 31% of the delayed recovery group was less than the 3rd percentile (p less than 0.05). It is concluded that children take a longer time to recover from the bacterial GE than from non-bacterial GE. The younger children will take a longer time to recover from an episode of diarrhoea. The body weight also plays an important role in recovery, reflecting the importance of nutrition in the process of recovery.

Acute Disease↗

Upper gastrointestinal endoscopy in children with abdominal pain.

Abdominal pain is a common gastrointestinal symptom in children. The purpose of this paper is to determine the upper gastrointestinal mucosal pathology in a group of children with abdominal pain. 48 consecutive children referred to the authors with the problem of abdominal pain were studied. These were divided into 2 groups. Those with only one episode of pain and lasting for less than 2 weeks were considered to have acute abdominal pain. Those with repeated episodes of pain and lasting for more than 2 weeks were considered to have recurrent abdominal pain. Careful clinical examination was done to exclude an acute surgical abdomen. Other common causes of abdominal pain in our population such as urinary tract infection, lactose intolerance, hepatitis and choledochal cyst were excluded by clinical examinations and laboratory investigations. Upper gastrointestinal endoscopy was done by one of the authors. Five out of the 16 children with acute abdominal pain had macroscopic features of acute gastritis and another 2 had duodenitis. In the other 32 children with recurrent abdominal pain, 5 had duodenal ulcers and 3 had reflux oesophagitis. It was concluded that upper gastrointestinal endoscopy was a useful means of identifying the upper gastrointestinal pathology in children with abdominal pain. 43% and 25% of the children with acute and recurrent abdominal pain respectively had a cause identified by gastroscopy.

Abdomen↗